Brief history of Italian psychiatric legislation from 1904 to the 1978 Reform Act.

A brief survey is given of the evolution of Italian psychiatric legislation. The following acts are examined: the 1904 law, stating that people affected by mental derangement must be kept in custody and treated in mental hospitals when they are dangerous to themselves or to others or create public scandal; the 1909 regulations, in which various aspects of mental hospital organization are dealt with; the 1968 law, sanctioning the institution of voluntary admission; the 1978 Reform Act. It is emphasized that the 1978 Italian mental health law is the only one, in the Western industrialized world, in which: 1) patient's dangerousness is not used as a criterion for commitment, and compulsory admission is restricted to therapeutic emergency cases; 2) it is established that compulsory admission of psychiatric patients must be implemented in general hospitals; 3) prolonged hospitalizations are discouraged, by stating that compulsory treatment should last as a rule seven days; 4) it is sanctioned the abolishment of mental hospitals. Moreover, stress is laid on the law's attention to community-based facilities, described as the places in which preventive, therapeutic and rehabilitative interventions relevant to mental diseases should be implemented as a rule.